The Priory Hospital in Roehampton has been rated Requires Improvement overall by the Care Quality Commission.
It was rated Requires Improvement for being safe and responsive. It was rated Good for being effective, caring and well-led, following the inspection in November 2017.
The rating of Requires Improvement was based on CQC’s inspection of the acute, eating disorder and children’s and young people’s services. CQC also inspected the substance misuse services, but it does not yet rate these.
There were a number of significant concerns, particularly about acute wards and substance misuse service provided at the hospital.
The layout of the three acute wards presented potential risks to the safety of the patients admitted to these wards. The risks to patient safety were greatest on East Wing. The layout over four floors, made it hard for staff to observe the many risk areas. Risks were also present on West Wing and Garden Wing including in the garden areas. These were a result of poor lines of sight and the presence of numerous ligature points.
The hospital said it was working to mitigate these risks. However, inspectors reported that the current physical environment of the building was not suitable for adults with acute mental health needs.
The hospital had recognised this and had stated its intention to relocate the service on East Wing and completely redevelop the West Wing and Garden Wing. The work is due to be completed by mid-November 2018.
Staff changes, the high use of agency staff unfamiliar with the wards, continued to be an issue and impacted on the consistency of care. Patients said that they did not like it when agency staff were on shift as they were unfamiliar with patient needs.
CQC also inspected the substance misuse services. CQC wrote to the provider expressing concerns about the safety of the patients undergoing medically assisted withdrawal and they voluntarily agreed to suspend admissions until these concerns were addressed.
However, inspectors did find areas of good practice at The Priory. Extra staffing on all of the acute wards enabled more observations and interactions with patients, so that patients felt better supported.
Care plans were holistic, personalised and demonstrated patient involvement. There was evidence of good physical health care management.
Staff demonstrated effective relationships with other services and organisations. The safeguarding lead had good working relationships with the local authority. The hospital sought to improve and keep up with best practice. Wards were providing treatment in line with The National Institute for Health and Care Excellence (NICE) guidance.
There was excellent involvement of young people on Lower Court. Patients sat on interview panels that recruited staff to work in the child and adolescent mental health services and were involved in the development of their therapeutic programme. For example, staff provided young people with Bluetooth cordless headsets, as normal headphones with cords were not allowed.
Patients spoke positively about staff interactions with them, and we observed staff engaging with patients discreetly and respectfully. Patients said the food was good quality. Patients particularly appreciated the hospital gym and were satisfied with the hospital accommodation.
The hospital had strong and responsive leadership. Senior managers visited the wards and consulted with staff regarding changes to services. Senior management had good oversight of the wards and had systems in place to track staff supervision, incidents, safeguarding and complaints for each ward.
Dr Paul Lelliott, Deputy Chief Inspector (and lead for mental health) said: "Despite the overall rating of Requires Improvement, we are hopeful that the leadership team is capable of making the improvements needed to achieve a rating of Good.
"There is still much to be done and work needs to be carried out to provide a much better environment for patients, especially on acute wards."
Read the report in full on the Priory Hospital profile page.
Ends
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There is still much to be done and work needs to be carried out to provide a much better environment for patients, especially on acute wards.
Dr Paul Lelliott, Deputy Chief Inspector (and lead for mental health)